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1783 Public Health and Poor Law. LOCAL GOVERNMENT BOARD. REPORTS OF INSPECTORS OF THE MEDICAL DEPARTMENT OF THE LOCAL GOVERNMENT BOARD. THE SANITARY CIRCUMSTANCES AND ADMINISTRATION OF VARIOUS RURAL AND SMALLER URBAN DISTRICTS. DURING the last few months the Local Government Board has issued a large number of reports which give detailed accounts of the results of visits by medical inspectors to rural districts and smaller urban districts in different parts of the country. These reports have in the main a local interest but it is impossible to look through the series without realising how frequently the system of sanitary government by district councils of these areas is found altogether inefficient in practice. The inspectors, after reporting on defective conditions of housing, undesirable or dangerous water-supplies, neglect to supervise cowsheds and milling, and many other matters which become almost monotonous by repetition, nearly always point to the unsatisfactory circumstances of the local public health service as the first matter on which reform is necessary. In many of these reports, combination of a number of adjoining districts for the purpose of securing a single specially qualified medical officer is advocated but unless the Local Government Board can be induced to abandon its well-known objections to compelling the combina- tion of unwilling districts for this purpose it is to be feared that much of the labour expended on these inspections and reports will have been thrown away. In regard to "inspectors of nuisances," or sanitary inspectors as they are generally called, the Board can indirectly bring about improvements by exercising its power of allowing or refusing repayment of half this officer’s salary from county funds. But it would appear from these reports that this is often an ineffective weapon, and obviously a district which elects to pay its inspector a merely nominal sum for nominal services has little to lose if the repayment of salary is refused by the Board. From the following reports a few matters of more than local interest have been noted for comment. Sherborne Rural District,1 by Dr. R. W. JOHNSTONE.-This is an important milk-producing district in Dorsetshire. Nearly all the cowkeepers dispose of their produce as milk ; few of them make either butter or cheese. About 6000 gallons of milk a day are sent out of this district for retail in London, Aldershot, and other places. In addition, about 1000 gallons a day are made into milk powder at a factory in Sherborne. Little or no attempt is made by the district council to enforce the regulations adopted under the Dairies, Cowsheds, and Milkshops Order. The water available for cooling the milk at the farms often fails to reduce the temperature of the milk below 600 F., and many of the cooling sheds are ramshackle affairs which readily permit the contamination of the milk by dust. "The surroundings are often so filthy that the dairyman has to pass through a quagmire to reach the cooling shed." In one cowshed the normal method of cleansing the shed was to shovel the manure through the windows, leaving the walls inside caked with filth. Uncleanliness and faulty construction of walls and floors of cowsheds were everywhere met with. Milkers as a rule do not wash their hands or cleanse the cows’ udders before milking. The large London dairies which deal with farmers in this district usually insist, in their printed agree. ments, upon the wearing of a clean blouse by the milker, cleansing of hands and udder, and like matters. But nc attempt seems to be made to find out if the farmer is fulfilling the conditions of his contract. Dr. Johnstone found that thE dairy farmers were more opposed to reform in the personal methods of their milkers than to any proposition in the wa of improved ventilation and drainage of the cowsheds. SomE of them said that if the regulations on this matter were insisted upon they would abandon dairy-farming. He add., that the sooner men with these ideas abandon dairy-farming the better it will be for the health of the children and others who consume the milk. 1 London: Wyman and Sons, Fetter-lane; Edinburgh : Oliver and Boyd; Dublin: E. Ponsonby. No. 285. Price 3d. Aberayron Registration District,2 by Dr. W. W. E. FLETCHER.-Inspection of the three districts comprised in this registration area (Aberayron urban and rural and New Quay urban) brought out the fact that the councils concerned completely neglected their elementary duties as to drainage, water-supply, closet accommodation, and other matters, and resulted in Dr. Fletcher raising the question of improving the public health service of the whole of Cardigan- shire by the combination of all its contained districts for the purpose of appointing a single medical officer of health. Dr. Fletcher points out that Westmorland has a combination of districts of this kind and that the results contrast favourably with those of Cardigan, in which there are no fewer than 13 medical officers of health who between them receive no . more than .B380 per annum. , Tregaron Rural District,3 by Dr. E. P. MANBY.-The shortcomings of sanitary administration in Cardiganshire are also brought out by this report. Public water-supplies are urgently needed in many parts of the district but the district council has refused to take action even in cases where the cost of carrying out the recommendations of the medical officer of health for this purpose would have been almost negligible. The council has recently appointed as its inspector of nuisances a draper’s assistant at a salary of lls. 6d. a week. The population of the district is about 8000 and its area is 189 square miles. Dr. Manby takes occasion to point out that the Dairies, Cowsheds, and Milk- shops Order applies to all cowkeepers whether they sell milk or only make cheese and butter, although in the latter case there is exemption from regulations made under the Order. Misconception on this matter appears to be prevalent, as reference is made to it in several reports of this series. Bourne Urban District,4 by Dr. F. ST. GEORGE MmART.- The abundance of water which is obtained in this district wherever the Lincolnshire limestone is bored into has incidentally given rise to some serious difficulties. An artesian well with an abundant yield can be made almost anywhere by sinking a shaft, and owners of houses and business premises naturally prefer this method of supply to resorting to the public service. A great many of these bores are not sealed properly and leakage is freely and constantly taking place into the ground in their neighbourhood. Among other objections to this leakage is the effect upon the sewage of the town. This amounts to more than 60 gallons per head of population in dry weather and the high degree of dilution greatly interferes with the satisfactory purification of the sewage at reasonable cost. Hicntingdon Rural District,5 by Dr. R. D. SWEETING.- The sanitary condition of a portion of this district has been adversely affected by neglect to cleanse streams and water- ways. In some places, such as Alconbury, serious floods appear to be increasingly common. This frequent flooding causes serious discomfort and inconvenience, and, as Dr. Sweeting points out, it obviously tends to foster the preva- lence of rheumatism, bronchitis, and various diseases asso- ciated with dampness of sites and dwellings. The streams in question are backwaters of the Ouse and there seems to be no public authority upon which their cleansing depends. The county council disclaims any such duty. The neglected con- dition of the streams, however, is not confined to the back- waters but extends to the river Ouse itself. After a prolonged litigation on the subject of repair of locks, which terminated by a decision in the House of Lords in 1904, all navigation on the Ouse above St. Ives has come to a complete standstill; the river is ceasing to be navigable and in the absence of dredging and weeding and repairs to the locks a fertile cause of local flooding is created. It may be hoped that the Royal Commission on Canals and Waterways may be able to make effective recommendations to improve the very unsatisfactory conditions which this report discloses. Hartley Wintney -Rural District,6 by Dr. J. S. Low.-In this district of Hampshire, which adjoins Farnborough, it has lately been the custom to receive town children sent by charitable persons for a country holiday. Dr. Low shows that the houses in which these children are received are often insanitary and become grossly overcrowded as a consequence 1 of their visit. He recommends that the local agent who arranges for the housing of the children should be required to give an undertaking that no dwelling should be used for the 2 Ibid., No. 283. Price 5d. 3 Ibid., No. 284. Price 3d. 4 Ibid., No. 289. Price 3d. 5 Ibid., No. 278. Price 6d. 6 Ibid., No. 288. Price 4d.
